High risk infants and families often experience significant difficulties as individual and as a family unit. Their risk may be due both to underlying handicapping condition in the infant and to unfavorable caretaking environments. Further, the interaction patterns for high risk infants frequently are different from those of normal infants and may contribute to the already existing potential for developmental difficulties. These factors make such infants and their families more likely to develop significant psychopathological problems requiring extensive and costly intervention at a later point. Based on existing knowledge, the present project is designed to develop and evaluate the effectiveness of several intervention strategies for high risk infants and families. Further, our goal is to develop a high risk referral system and a program of services that will allow families of high risk infants to receive support and care necessary to facilitate their development. The project will include the identification of potential hearing, language, and speech difficulties, which may occur with greater frequency and contribute to developmental difficulties in high risk babies, and the development of appropriate physically and psychologically based interventions for infants with developmental and psychosocial problems. Two hundred infants from the Neonatal Intensive Care Unit, 200 infants and young mothers (ages 17 and under), and 100 full term infants and mothers will be followed over a three year period. Half of the M & Is and half of the NICUs will receive intervention and half will not. Interventions offering support, developmental guidance, and assistance with the parent-infant relationship will begin in the hospital and will be carried out primarily through home visitors. A "Warm Line" will be available on a 24 hour basis for parents who are concerned about their children. If significant problems are identified, appropriate referrals and services will be offered. Evaluations of the developmental status of the child and the adaptation of the parents will be carried out for all groups. The objective of the project is to evolve effective programs of intervention for high risk infants and families which will facilitate their optimal growth and development.